The duration of deafness among device nonusers was statistically significantly longer than the duration of deafness among regular device users (median difference, 6.84 95% CI, 4.02-9.58).Ĭonclusions and Relevance This systematic review and meta-analysis found that cochlear implantation for children with SSD was associated with clinically meaningful improvements in audiological and patient-reported outcomes shorter duration of deafness may lead to better outcomes. Patients with acquired SSD and shorter duration of deafness compared with those with congenital SSD reported greater improvements in speech (MD, 2.27 95% CI, 1.89-2.65 vs 1.58 95% CI, 1.00-2.16) and spatial (MD, 2.95 95% CI, 2.66-3.24 vs 1.68 95% CI, 0.96-2.39) hearing qualities. Sound localization as measured by degrees of error from true location (mean difference, –24.78° 95% CI, –34.16° to –15.40° I 2 = 10%) improved statistically significantly after cochlear implantation. Long duration of deafness (>4 years in congenital SSD and >7 years in perilingual SSD) was the most commonly proposed reason for lack of improvement. Most children showed clinically meaningful improvement in speech perception in noise (39 of 49 children ) and in quiet (34 of 42 children ). Results Twelve observational studies that evaluated 119 children (mean age, 6.6 years) with SSD who received a cochlear implant were included. Main Outcomes and Measures Outcomes were (1) postoperative changes in speech perception (in quiet was measured as a proportion of correct responses, and in noise was measured as decibel signal to noise ratio for speech reception threshold) and sound localization (measured in degree of localization error), (2) patient-reported audiological outcomes (measured by the speech, spatial, and qualities of hearing scale), and (3) device use rates among children who received cochlear implantation for SSD. The following information was obtained from each article: study characteristics, patient characteristics, hearing loss and intervention characteristics, and outcomes. Data were pooled using fixed-effect and random-effect models. Of the 526 articles reviewed, 12 (2.3%) met the selection criteria.ĭata Extraction and Synthesis The Meta-analyses Of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. Study Selection Inclusion criteria were designed to capture studies that evaluated pediatric patients (1) younger than 18 years, (2) with a diagnosis of SSD for which they underwent a cochlear implantation, and (3) with at least 1 outcome of interest measured numerically: speech perception, sound localization, device use, and patient-reported outcomes. Objective To evaluate the audiological and patient-reported outcomes in children who underwent cochlear implantation for SSD and to assess the association between time of implantation, subjective outcomes, and cochlear implant device use rates.ĭata Source MEDLINE, Embase, Scopus, Cochrane, and PubMed were searched for English-language articles that were published in a peer-reviewed journal from database inception to February 18, 2020. The absence of robust clinical data specific to pediatric patients to guide shared decision-making and to identify potential advantages is a challenge in family counseling. Importance In 2019, the US Food and Drug Administration approved cochlear implantation for children with single-sided deafness (SSD). Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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